title: Processes of in-hospital psychiatric care and subsequent criminal behaviour among patients with schizophrenia: a national population-based, follow-up study.
abstract: OBJECTIVE
  It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients with schizophrenia.
  
  
  METHODS
  Danish patients with schizophrenia (18 years or older) discharged from a psychiatric ward between January 2004 and March 2009 were identified using a national population-based schizophrenia registry (n = 10 757). Data for in-hospital care and patient characteristics were linked with data on criminal charges obtained from the Danish Crime Registry until November 2010.
  
  
  RESULTS
  Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among patients receiving the most processes of in-hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment and staff contact with relatives.
  
  
  CONCLUSIONS
  High-quality, in-hospital psychiatric care was associated with a lower risk of criminal behaviour after discharge among patients with schizophrenia.
authors.affiliation: Researcher, Department South, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark.
authors.forename: Charlotte Gjørup
authors.initials: CG
authors.lastname: Pedersen
authors.forename: Signe
authors.initials: S
authors.lastname: Olrik Wallenstein Jensen
authors.forename: Søren Paaske
authors.initials: SP
authors.lastname: Johnsen
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
authors.forename: Jan
authors.initials: J
authors.lastname: Mainz
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D057237:Criminals / Q000523:psychology / Q000706:statistics & numerical data; D003617:Dangerous Behavior; D003718:Denmark / Q000453:epidemiology; D004637:Emergency Services, Psychiatric / Q000379:methods / Q000592:standards; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D010351:Patient Discharge / Q000592:standards; D011567:Psychiatric Department, Hospital / Q000592:standards / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D058996:Quality Improvement; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012565:Schizophrenic Psychology; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D014150:Antipsychotic Agents
keywords: criminal; quality indicators; register; schizophrenia; violence